Browsing by Author "Diltata Girma"

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    The Cost of Acute Stroke Care and Associated Factors in Tertiary Hospitals Addis Ababa,Ethiopia.
    (Addis Abeba University, 2021-06) Ali Kemal; Mamushet Yared; Alemayehu Biniyam ; Diltata Girma; Tassew Berhan
    Aim: Stroke is the commonest neurologic ward admission diagnosis in Ethiopia. It createssignificant economic burden on the health care system. The acute stroke care cost is a majorcomponent of the annual cost for stroke. In this study, we aimed to determine the total acutestroke care cost per patient admitted to a tertiary level government hospital in Addis Ababa,Ethiopia. And to identify components and predictors of the costs in order to better estimate theoverall cost of stroke. Materials and methods: This prospective study was done in Tikur Anbesa specialized hospital andYekatit-12 hospital medical college on ward admitted patients between December 2020 andOctober 2021. All ward and ICU admitted stroke patients during the study period were enrolled.Direct and indirect costs from first stroke attack up to discharge were obtained. We used multiplelinear regression analysis to determine factors associated with hospital cost. Results: A total of 118 stroke patients admitted to the study hospitals were enrolled and finalanalysis was performed on 99 patients. The mean acute stroke care cost per patient at the studyhospitals was 14616.5 birr (228.3USD), direct and indirect costs 10209.55 birr (214.4 USD) and 4514.6 birrs (94.8 USD) respectively. The average length of stay was 9.38 days. Multiple linearregression analysis of the natural log of the total acute stroke care cost showed variation in costswere largely attributable to: the length of hospital stays, ICU admission and rural residence. Conclusions: Acute stroke care cost in Addis Ababa, government tertiary hospitals are lower than previous African studies. Direct medical cost contributes the majority of acute stroke care cost.Length of hospital stay and ICU admission were the cost driving factors.
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    Knowledge, Attitude and Practice of New Stroke Patients and their Caregivers towards Stroke: a Hospital Based Interview
    (Addis Ababa University, 2017-11) Diltata Girma; Ali Seid
    Background: Nearly three out of four deaths due to stroke in the world occur in low income and middle income countries – the majority are sub-Saharan African (SSA) countries. A rapidly rising stroke incidence in SSA created a large burden on the resource limited public health care. Stroke is one of the leading causes of adult onset disability in this region. Despite these impacts,very low level of awareness about stroke by the public is reported from a few studies done in SSA. In Ethiopia, there is no single study done that assesses knowledge, attitude and practice (KAP) of individuals towards stroke. Studying KAP of the victims towards stroke is essential step to improve public awareness and health care delivery system through community healtheducation. Objective: This study was conducted to assess the baseline KAP of new stroke patients and their attending caregivers towards stroke. Methods & analyses: A facility – based, quantitative, cross – sectional, descriptive study was conducted. All new stroke patients and their attending caregivers were sampled from three teaching hospitals over a period of seven months. Standardized pretested mixed open ended and closed ended questionnaire was used to collect data from eligible 39 patients with new stroke and 214 caregivers of 77 new stroke patients. The questionnaire was administered face to face with in the first few hours or days after each new stroke patient’s admission to medical emergency unit or general medical ward of respective hospitals. A written informed consent was obtained fromeach study participants before the interview. The response rate among the selected participants was more than nighty percent (90.5%). Every study participant was given a short health education about stroke at the end of the interview. Protocol approvals were obtained from the Ethical Review Committee of the Department of Neurology. Data was entered and analysedusing SPSS/PC version 20.0 software packages. Results & conclusions: Among 253 respondents 36% identified brain as the primary organ affected by stroke. Only about 11% knew three or more stroke warning signs/symptoms. The most frequently identified stroke symptom was sudden onset unilateral extremity weakness ( ).Approximately one in five (21%) participants was able to mention three or more risk factors of stroke but 40% respondent were unable to mention a single biologically plausible risk factor.16% of respondents believe that stroke is associated with spiritual possession. Those who prefer to call ambulance or a health professional for immediate help were 111(~44%). A large proportion (41%) of individuals mentioned one or more culturally plausible but potentially dangerous practices that they would provide for unconscious stroke victims. Frequently mentioned wrong practices include giving sips of water or soft drinks, putting some food in the victims mouth, and sprinkling holly water on the patients face as first aid measures. Higher level
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    Stigma among Stroke Survivors in Ethiopia: Experience from a Tertiary Hospital Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-11) Tsegaye Keberte; Mamushet Yared ; Alemayehu Biniyam ; Diltata Girma
    Background:Stigma among neurologic disease is a widely recognized global health issue. The negative impact it has on different neurologic diseases has been described. Although stroke survivorshave different degree of stigma which may contributes to negative outcomes, there isshortage of study on stigma among stroke survivors and its predictors, especially in low andmiddle income countries. Study title:Stigma among stroke survivors: Experience from a tertiary hospital in Addis Ababa, Ethiopia Objective: To assess the prevalence of stigma and its associated factors among stroke survivors havinga follow up at the Neurologic Out-patient Clinic in Tikur Anbessa Specialized Hospital. Methods: Institution based quantitative cross sectional study was conducted among 123 stroke patients having a follow up at Tikur Anbessa Specialized Hospital Neurology Out-patient Clinics.Data were collected by interviewer administered questionnaire. Stigma was measured usingStigma scale for chronic illness (SSCI-8) tool and included self, family, and community perceived stigma. Depression was assessed using Patient Health related Questionnaire(PHQ9), and functional status using modified Rankin Scale. Data were entered and analyzedusing Statistical Package for Social Sciences (SPSS V25) software package. Binary logisticregression and multinomial logistic regression was used. Adjusted odds ratios with 95%confidence interval were used to identify associated factors with perceived stigma. Results:Overall, the prevalence of perceived stigma was 55%. For the perceived family andcommunity, it was 17.9%, and 13.8% respectively. Functional disability [moderate to severedisability (AOR=6.88, CI: 2.257, 22.46) P=.001.], Depression (AOR=19, CI: 2.24,161.34)P=.007 and residual weakness (AOR=9.71, CI: 0.94, 94.95) P=.051were factorsassociated with perceived stigma in stroke patients. Conclusion and recommendation: Around half of stroke survivors who participated in this study described some form ofperceived stigma. The personal perceived stigma was higher when compared to family orcommunity perceived stigma. Factors associated with perceived stigma were Depression,residual weakness post stroke, and moderate to severe disability functional status. Therehabilitation services for patients with stroke should be strengthened. These should includephysical, emotional, and social aspect of disabilities. In addition, establishing patient supportgroups for stroke survivors, and educating the community about stroke may be important to address stigma.